Dan & Zara
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FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Aug 29, 2020 15:05:25 GMT -7
[Original subject line: 3 months of pain saw some results with Conservative ]
I own a beautiful 5 yr old little dog named Zara she is chihuahua/pom mix and about 3 months ago she started yelping when she would jump.. was reluctant to go down stairs would sit in her corner not eat or be active. we did an X-ray and it showed narrowing of c6-c7 T12 - T13 and L1 disc spaces. the only pain she resembles is in her neck. was prescribed Rovera and it messed up her stomach! stopped the rovera and started .5MG of pred almost instantly she was better.. well this went on for 2 months she would be on pred finish her dose then have about a 14 day washout period and then the pain would come back.. we were not crate resting her at this time.
Finally about a month ago we saw a Neurologist who recommended strict crate rest for 4 weeks.. well her washout period went from 14 days to 24 days so after the 4 weeks I let her out gradually thinking she was better FINALLY.
I took her to get groomed last Weds [8/26] and after home she didn't want to eat hiding her food with her nose and now is back in her corner with pain... did I let her out too soon?? right now she is on pregablin for pain it helps but nothing like the pred for inflammation + she walks like a drunk sailor and that's no fun. so I saw neurologist again yesterday she said [8/28] Zara passed her pre exam with flying colors no sign of pain... probably because of the pregablin but at home at night she's back in her corner with pain walks very slow, low neck carriage.
our next option is MRI and possibly a spinal tap to rule out any canine menagitis - Very expensive
or should I try crate rest again with the pred but this time a little longer than 4 weeks? we've done 2 rounds of blood work to make sure her numbers are not being affected by the steroids and its perfect every time - a higher platelet count because of the rounds of steroids. we also had an ultrasound done on her stomach everything came back perfect but.. - inflammation ( mucosal fibrosis associated with inflammatory cell INFILTRATES) no sign of fever or infections.
Thank you.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Aug 29, 2020 18:33:15 GMT -7
Dan, so sorry to hear so many disc problems for your little Zara. We've never hear of harm from crate rest, but we often hear sad stories when 8 weeks of crate rest to allow the disc to heal is shorted when dealing with a disc episode. There are three kinds of pain with a neck disc. --- Pregabalin is for nerve pain --- Tramadol as the over all general analgesic --- methocarbamol for muscle contraction pain. None of us here are vets. We depend on the diagnosis of a vet and then we have lots of information to share in caring and advocating for your dog. So you will need to discuss things with your vet if you are to go with ruling out meningitis with the tap. If you and your vet decide to lean towards a disc episode, then give t hat disc time to heal with the full 8 weeks of very STRICT rest inside of a recovery suite to avoid a relapse to the healing and forming disc scar tissue. The principals to follow with true conservative treatment are here as well as super good ideas and tips to help make that time go smoother. dodgerslist.com/2020/05/14/strict-rest-recovery-process/STRICT rest 24/7 during conservative treatment means: ◼︎ no laps ◼︎ no couches ◼︎ no baths ◼︎ no sleeping with you ◼︎ "no chiro therapy whys": dodgerslist.com/2020/04/22/chiropractic/◼︎ no dragging or meandering at potty times ◼︎ no PT for conservative dogs MED LIST Let us know how many mgs pregabalin you give each dose and how many times a day. And what direction you and your vet decide to go in. |
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Dan & Zara
New Member
FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Aug 30, 2020 8:19:28 GMT -7
she was prescribed 1/2 ML of Pregablin for pain we did that for a few days and it Knocked her out so we found an effective dose at .20ML I give it to her at night and the next morning she seems to be a little better she will drink water and eat.
She has no problem walking etc.. she does have low neck carriage [pain] and she will stretch her neck upwards. no fever so that's why I keep thinking this is a perhaps disc bulge or herniated disc vs SRMA she has always been a jumper! she jumped off a high bed 1 month before this all started on accident of course.. I started to noticed when she would try to jump on couch she would have a hard time doing it.. then the day came when she would greet me and yelp when she would jump. I was reading IVVD could be gene related so I did a gene test on her too and she came back without the gene for IVVD disease
I truly believe if I go back and crate rest her another 8 weeks vs the first 4 weeks with a round of pred and her pregablin she will be able to heal. vs MRI and if this fails then I will have no other choice than to do the MRI
but almost instantly she is better once she has one 2.5 pill of pred
we have only truly tried to crate rest her one time and it was just 4 weeks.. I was reading to gradually bring her back out to the world yeah we def gave her run of the house when she was out...
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Aug 30, 2020 8:53:45 GMT -7
Dan, the current gene tests out are likely flawed and not to be trusted. A dog born with IVDD and showing signs (of pain, neuro deficits) is normally diagnosed with a hands on neuro exam, the breeds (CHIs, POMs... prone to IVDD, and the way the dog acts at the exam. The vet can then rule out several of the diseases that mimic IVDD and put in first position the disease most likely causing the symptoms. Xrays do not prove a current disc episode. If a suspicion that hard boney tissue is involved with a suspected disease, then an x-ray can rule out broken vertebrae from a fall or dog attack, bone infection disease, etc. Xrays do not show soft tissue such as the spinal cord nor the disc. IF this is a neck disc, here are the extra's you can do at home to help: dodgerslist.com/2020/05/05/cervical-care-tips/Before seeing the vet, time the dose of pregabalin 8 hrs before the vet visit. That way he has the best chance to give a good diagnosis without the pregablin masking pain. Zara is currently in pain evidenced by your current reporting of holding her neck in a low position or holding the head high. It is better to be a bit groggy if you need to up the .20mL a bit to provide full comfort. QUESTIONs
1) How many mgs of pregablin are in one mL of the liquid? That info should be on the bottle.
2) How many times a day are you actually giving pregablin? Did the vet also give you a range you could give?
3) Prior to the neuro suggesting meningitis possibility, we he aware after 4 wks no gradual intro to physical activity? That she was still taking pain-masking pregabalin? Let us know what your vet thinks and prescribes on Monday for additional pain meds and which anti-inflammatory he chooses. --- Excellent review why Pepcid AC and the 6 things to know about anti-inflammatories to have under your belt as you discuss things with your vet: dodgerslist.com/2020/05/06/stomach-protection/ |
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Dan & Zara
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FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Aug 30, 2020 9:03:03 GMT -7
she has seen the Neurologist twice this past time she could not find anything wrong with her and she was just on pregablin... for the most part she is a very healthy dog.. but can't make full yawns like she used to and without the meds she goes in her corner. usually used to run around and act crazy. I am thinking about just doing the MRI to finally get a diagnosis if it something minor or serious at least we will know.. tired of seeing her walk around very slow and not being herself. She does so much better on the pregablin which tells me this has to be nerve related but where??
can you tell me if MRI are considered safe in dogs? that's one of the reasons why I have been holding back due to she has to be put under for it.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Aug 30, 2020 9:19:30 GMT -7
All imaging pictures require anesthesia to get really clear pictures by having the dog immobilized. Those highly trained in MRIs understand with IVDD disease a dog's main defense against further disc damage depends when awake having ability to control the core trunk muscles – this defense is eliminated when under anesthesia. They will keep the dog's back in one plane horizontal to the ground, avoid twisting the back or neck. Supporting both ends when adjusting the sleeping dog for the picture.
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Dan & Zara
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FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Aug 31, 2020 8:14:16 GMT -7
I think my wife and I are going to try strict crate rest one more time... since we let her out 4 weeks vs 8 weeks... + we did see some improvement our last go around vs no crate rest 26 days pain free vs 14 days.
Thoughts? if this does not resolve the problem then we will have to do an MRI
Our treatment action is going to be prednisone + pregablin
first 3 days 2.5 pred every 12 hours
one a day of 2.5 for 3 days
then one every other day for 3 days
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Aug 31, 2020 9:26:37 GMT -7
Dan, please supply the important part of prednisone treatment details. How much does Zara weigh? Without knowing weight can't determine if a very short course 3-day course of pred at 2.5mgs 2x/day is up at the anti-inflammatory level or at a taper level. A vet must just take a guess as to how long the first Pred course should be. Some choose a 7 or a 14 day course. The lowered or tapering doses do not work on inflamed tissue. The taper is to signal the body to again make its own steroid hormone. The taper provides a very important window into whether that course of pred actually got rid of all swellling/inflammation. The taper is the time for the owner to be alert to watching for pain or worsening neuro function. Pain, neuro diminish signals the vet to try another pred course with another test taper. Somewhere in the range of 7-30 days pred will be able to get rid of all swelling in the spinal cord. Disc healing takes 8 weeks of 100% STRICT rest. Please d/lw and tape to your fridge the ROADMAP to conservative treatment. That way you will have handy the other two phases of healing. You will be reminded not to take any dangerous detours. Here is the link to the ROADMAP dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdfThis is what the ROADMAP will look like taped to your fridge **  |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Aug 31, 2020 9:29:41 GMT -7
Also please provide the full information about pregabalin
1) How many mgs of pregablin are in one mL of the liquid? That info should be on the bottle.
2) How many times a day are you actually giving pregablin? Did the vet also give you a range you could give?
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Dan & Zara
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FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Aug 31, 2020 10:11:17 GMT -7
Zara weighs 12 pounds
[Moderator's Note. Please do not edit
12 lbs
Pregabalin ?mgs in one mL liquid?: ?mgs (1/2mL) 3x/day
[below 8/31 post: "currently is on no medication but Pregab" ]
In the past this Pred course is what's helped her get rid of the inflammation our first two rounds no crate rest our last round crate rest.
Her prescribed dose was 1/2 ML of of Pregab every 8 hours as needed for pain. We usually give it to her once in the evening and she is fine throughout the day id say about 70% back to normal still walking slow though with low neck carriage right now I give .20-.25 of Pregab she can lower her neck to eat and drink water etc.. the 1/2ml was way too much and it made her very sleepy and wobbly.
with Zara we start seeing changes in her the second her first 2.5 pill is given of pred
I see no side effects on the pred for Zara... only a little panting at night and sometimes a little belly + increased hunger but when it comes to stomach no side effects so far
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Aug 31, 2020 10:56:01 GMT -7
Dan, let's zero in on the valuable missing information we need. TIP for clear communications -- Use a date for complete accuracy. -- "we start seeing changes" is confusing. It makes us think the changes have not yet happened OR that changes happened in the past. Using a date makes things very, very clear. Example: Today, 8/31, we see pain, low neck, etc. QUESTIONS -- What date did you start prednisone 2.5mgs 2x/day for three days? -- How many mgs of pregabalin are in one mL of liquid? Look on the bottle for that formula information it is supposed to be written on the bottle. OR call the clinic where the receptionist can give that answer. ALERT THE VET right now about pain -- Walking slow and low neck today, 8/31, means the pain meds are WAY, WAY under medicated for this disc episode! -- Advocate for the usual 3 different pain meds. Each of the three different pain meds work on a different kind of pain. 1) Tramadol works on overall general pain. Advocate for this pain med (Rx should be for 3x/day) 2) Pregabalin. DO NOT be SKIMPY in giving Pregabalin. Provide Zara's body the full high-level of pregabalin all day long. Give Pregabalin 3x/day promptly every 8 hrs during this disc episode. 3) Methocarbamol works on the VERY, VERY typical muscle contraction pain. Advocate for this pain med (Rx should be for 3x/day). PEPCID AC (famotdine) Do not expose your sweet, precious Zara to another medical problem on top of having to deal with a disc episode. Protect her stomach today 8/31, from extra stomach acids that can cause dangerous bleeding ulcers. SIMPLY ask your vet. Does my Zara have any health problems that she may not use Pepcid AC (famotidine)? The answer you want is a NO health issues or YES she has a heart issue, a liver issue or a kidney issue. If you get a NO health issue then go to the grocery store to buy Pepcid AC. Give 5mgs Pepcid AC every 12 hours (2x/day) These are NOT acceptable answers: she doesn't need Pepcid AC, let's wait to see if she needs it. RE-ASK: Does my Zara have any health issues? Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. Excellent reading on anti-inflammatory prednisone use with PEPCID AC: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ |
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Dan & Zara
New Member
FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Aug 31, 2020 11:37:45 GMT -7
her last pred was July 29th she started to feel bad again on august 24 when I started to let her out in the world again. after only 4 weeks of rest. I will get that pregab amount here shortly.
she currently is on no medication but Pregab
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Aug 31, 2020 12:02:20 GMT -7
If you are going to try conservative treatment it involves
--- an anti-inflammatory Steroid such as prednisone or a non-steroid NSAID.
--- With a new disc episode getting the anti-inflammatory the very soonest possible is KEY to bringing down the painful spinal cord swelling. Time matters getting anti-inflammatory on board.
--- With a new disc episode getting the the correct combinations of typically 3 pain meds is KEY so that Zara is not suffering as she is today, 8/31, with slow walking, lowered head.
What date are you and your vet going to start conservative treatment (anti-inflammatory + pain meds + stomach protector AND 100% STRICT rest inside of a recovery suite)?
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Dan & Zara
New Member
FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Sept 1, 2020 14:34:27 GMT -7
We went ahead and had an MRI on Zara today...her spine is beautiful the Neurologist told us.
She was Diagnosed with meningitis of the spine after some testing we will know which kind..but since she responds to pred so well they think she has SRMA so treatment will be pred and antibiotics.
Thanks for everything
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Post by Romy & Frankie on Sept 1, 2020 14:46:39 GMT -7
I am sure it is a relief to have a definitive diagnosis and good news that she is responding well to the pred.
Healing thoughts for Zara
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Dan & Zara
New Member
FEMALE - Chi/pom mix
Posts: 9
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Post by Dan & Zara on Sept 1, 2020 15:30:26 GMT -7
Thank you I am emotionally exhausted. she was in so much pain last night I thought it was not fair anymore not knowing what we were dealing with.
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Post by Romy & Frankie on Sept 2, 2020 13:15:25 GMT -7
At Dodgerslist we know only one disease IVDD. That being said, vets have many ways to treat pain regardless of the cause. Please let the vet know she is in severe pain and advocate for an adjustment of pain meds.
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